Individual
AHMED MANSOUR MANSOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1656 CHAMPLIN AVE, UTICA, NY 13502-4830
(315) 624-6241
(315) 624-6395
Mailing address
1656 CHAMPLIN AVE, UTICA, NY 13502-4830
(315) 624-6241
(315) 624-6395
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
272455
NY
207V00000X
Obstetrics & Gynecology Physician
MD456254
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03787506
—
NY
05
—
1031257090004
—
PA
Enumeration date
10/30/2008
Last updated
04/07/2017
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